How Can We Reduce Pediatric Cancer Treatment Abandonment in Low- and Middle-Income Regions?

Interventions that combined socioeconomic support, psychosocial support, and clinical care improvements yielded the greatest reductions in pediatric cancer treatment abandonment in low- and middle-income countries, according to a scoping literature review of 24 studies.

“Our scoping review describes interventions that were associated with reduced pediatric cancer treatment abandonment in [low- and middle-income countries],” described by Srinithya Gillipelli, of Baylor College of Medicine in Houston, Texas.

The researchers also found that survival outcomes “improved in many studies” with these interventions. Data were presented at the 2024 ASPHO Conference.

The meta-analysis reviewed the MEDLINE Ovid, Embase, Web of Science, CINAHL, and Cochrane databases for studies that included patients aged 18 years or younger, were conducted in World Bank income classification-defined low- or middle-income countries, and described both pre- and postintervention treatment abandonment outcomes.

The enrolled studies included nine from the Americas, eight from the Southeast Asian region, four from the African region, and three from the Western Pacific region. Six studies solely evaluated socioeconomic support, five solely evaluated improved clinical care, and five solely evaluated improved education or psychosocial support. Of the remaining studies, four each evaluated a mixture of either two or three categories.

Reportedly, all 24 studies observed a decrease in pediatric cancer treatment abandonment after the intervention. The authors reported a median absolute risk reduction of 16% (range, 1%-55%) and a median relative risk reduction of 40% (range, 24%-100%). Survival “generally improved” in the 14 studies that reported survival data.

“These findings suggest that treatment abandonment can be effectively reduced and survival outcomes improved in [low- and middle-income countries] with targeted interventions aimed at augmenting clinical care and patient support,” Dr. Gillipelli and colleagues concluded.

Reference

Gillipelli S, Schaeffer A, McAtee C, et al. Interventions to reduce pediatric cancer treatment abandonment in LMICs: a scoping review. Poster #623. Presented at the 2024 American Society of Pediatric Hematology/Oncology Conference; April 3–6, 2024; Seattle, Washington.